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General NPI Number Information
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NPI Number | 1962676262
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Entity Type | Organization
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Legal Business Name | DAVID R HENDRICK DDS PA
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 1315 WILKESBORO BLVD NE
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City | LENOIR
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State | NC
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Zip | 28645
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Country | US
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Telephone | 828-754-3531
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Fax | 828-754-9866
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Provider Business Mailing Address
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Address Line | 1315 WILKESBORO BLVD NE
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City | LENOIR
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State | NC
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Zip | 28645
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Country | US
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Telephone | 828-754-3531
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Fax | 828-754-9866
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Authorized Official
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Title or Position | OWNER
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Name | DAVID RAY HENDRICK
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Credential | DDS
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Telephone | 828-754-3531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | NC6442
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License Number State | NC
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